- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $18,620.87 / $26,302.68
| Facility | | $12,589.25 | $18,620.87 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $12,882.50 / $21,877.62
| Facility | | $4,786.30 | $12,882.50 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $15,135.61 / $25,703.96
| Facility | | $11,220.18 | $15,135.61 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $16,982.44 / $25,118.86
| Facility | | $13,803.84 | $16,982.44 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $16,595.87 / $23,988.33
| Facility | | $8,709.64 | $16,595.87 | $23,988.33 |